Prevalence and determinants of non-alcoholic fatty liver disease in lifelines: A large Dutch population cohort

Non-alcoholic fatty liver disease is an increasing health issue that develops rather unnoticed with obesity, type 2 diabetes mellitus and metabolic syndrome. We investigated prevalence, determinants and associated metabolic abnormalities of non-alcoholic fatty liver disease in the largest population...

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Published in:PloS one Vol. 12; no. 2; p. e0171502
Main Authors: van den Berg, Eline H., Amini, Marzyeh, Schreuder, Tim C. M. A., Dullaart, Robin P. F., Faber, Klaas Nico, Alizadeh, Behrooz Z., Blokzijl, Hans
Format: Journal Article
Language:English
Published: United States Public Library of Science 02.02.2017
Public Library of Science (PLoS)
Subjects:
Abnormalities
Adult
Alanine
Alanine transaminase
Alcohol use
Alcoholic beverages
Alcoholic liver diseases
Alkaline phosphatase
Biochemical characteristics
Biochemistry
Biology and Life Sciences
Blood pressure
C-reactive protein
Cardiovascular diseases
Cholesterol
Cholesterol, HDL - blood
Cirrhosis
Comorbidity
Cross-Sectional Studies
Demographic aspects
Density
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - complications
Endocrinology
Epidemiology
Fasting
Fatty liver
Female
Gastroenterology
Gastrointestinal surgery
Glucose
Health risk assessment
Health risks
Hemoglobin
Hepatitis
Hepatology
Humans
Hyperglycemia
Hyperglycemia - complications
Hypertension
Hypertension - complications
Immigrants
Kidney diseases
Laboratory testing
Leukocytes
Liver
Liver cirrhosis
Liver diseases
Male
Medicine and Health Sciences
Metabolic disorders
Metabolic syndrome
Metabolic Syndrome - complications
Middle Aged
Missing data
Mortality
Netherlands - epidemiology
Non-alcoholic Fatty Liver Disease - epidemiology
Non-alcoholic Fatty Liver Disease - etiology
Obesity
Platelets
Population
Prevalence
Renal function
Risk Factors
Smoking
Triglycerides
Type 2 diabetes
Netherlands
Germany
ISSN:1932-6203, 1932-6203
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Summary:Non-alcoholic fatty liver disease is an increasing health issue that develops rather unnoticed with obesity, type 2 diabetes mellitus and metabolic syndrome. We investigated prevalence, determinants and associated metabolic abnormalities of non-alcoholic fatty liver disease in the largest population-based cohort to date. Biochemical characteristics, type 2 diabetes mellitus and metabolic syndrome were determined in the Lifelines Cohort Study (N = 167,729), a population-based cohort in the North of the Netherlands. Non-alcoholic fatty liver disease was defined as Fatty Liver Index (FLI)≥60. Exclusion criteria were age <18 years, immigrants, missing data to assess FLI and metabolic syndrome, excessive alcohol use, previous-diagnosed hepatitis or cirrhosis and non-fasting blood sampling. Out of 37,496 included participants (median age 44 years, 62.1% female), 8,259 (22.0%) had a FLI≥60. Individuals with a FLI≥60 were more often male, older, obese, had higher levels of hemoglobinA1c, fasting glucose, liver enzymes, total cholesterol, low-density lipoprotein cholesterol, triglycerides, c-reactive protein and leucocytes and lower high-density lipoprotein cholesterol (all P<0.0001). Participants with a FLI≥60 showed higher prevalence of type 2 diabetes mellitus (9.3% vs. 1.4%), metabolic syndrome (54.2% vs. 6.2%), impaired renal function (20.1% vs. 8.7%) and cardiovascular disease (4.6% vs. 1.6%) (all P<0.0001). Multivariable logistic analysis showed that smoking, hemoglobin, leucocytes, c-reactive protein, platelets, alanine aminotransferase, alkaline phosphatase, albumin, impaired renal function (OR 1.27, 95%CI 1.15-1.41), metabolic syndrome (OR 11.89, 95%CI 11.03-12.82) and its individual components hyperglycemia (OR 2.53, 95%CI 2.34-2.72), hypertension (OR 1.89, 95%CI 1.77-2.01) and reduced high-density lipoprotein cholesterol (OR 3.44, 95%CI 3.22-3.68) were independently associated with suspected non-alcoholic fatty liver disease (all P<0.0001). Twenty-two percent (22.0%) of the population in the North of the Netherlands is suspected to suffer from non-alcoholic fatty liver disease, coinciding with a significant increased risk of type 2 diabetes mellitus, metabolic syndrome, cardiovascular disease and impaired renal function.
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Competing Interests: The authors have declared that no competing interests exist.
Conceptualization: EB MA TS RD KNF BA HB.Data curation: EB MA BA.Formal analysis: EB MA.Investigation: EB.Methodology: EB MA BA HB.Supervision: HB.Validation: MA BA.Visualization: EB.Writing – original draft: EB.Writing – review & editing: EB MA TS RD KNF BA HB.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0171502